Although women now make up approximately half of medical school graduates worldwide, their representation in surgical specialties remains disproportionately low. This disparity is shaped not only by institutional barriers but also by cultural and societal norms that influence women’s career trajectories, family responsibilities, and leadership opportunities. Across the globe, surgery is still perceived as a male-dominated profession, with women facing implicit bias, limited mentorship, and patient perceptions that undermine their authority. In many low- and middle-income countries, women also struggle with inadequate structural support such as childcare, maternity leave, and safe working conditions. Conversely, advocacy networks and international collaborations are beginning to shift the paradigm, creating spaces where women surgeons are increasingly visible and supported. This chapter examines the interplay between culture, gender expectations, and societal roles in shaping women’s participation in surgery across diverse regions. By highlighting both challenges and progress, it emphasizes the urgent need for policies and cultural shifts that ensure equity, representation, and inclusion in surgical practice worldwide.